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16 Prerenal ARF of Children The most common cause of ARF Prerenal ARF:  The most common cause of hypovolemia in children is gastroenteritis.  Congenital and acquired heart diseases are important causes of ARF in this age group.

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20 Acute Tubular Necrosis  Tubular diseases: Acute tubular necrosis (Absence of arterial or glomerular lesions). There are major histologic changes that take place in ATN: (1) tubular necrosis with sloughing of the epithelial cells (2) occlusion of the tubular lumina by casts and by cellular debris (3)Back leak of filtrate

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23 Intrinsic ARF of Children  Hemolytic uremic syndrome (HUS) is the most common cause of ARF in children.  The disease is associated with a diarrheal prodrome caused by Escherichia coli Children usually present with microangiopathic anemia, thrombocytopenia, colitis, mental status changes, and renal failure.

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Types of Access Temporary site AV fistula – Surgeon constructs by combining an artery and a vein – 3 to 6 months to mature AV graft – Man-made tube inserted by a surgeon to connect artery and vein – 2 to 6 weeks to mature

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Temporary Catheter

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AV Fistula & Graft

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What This Means For You No BP on same arm as fistula Protect arm from injury Control obvious hemorrhage – Bleeding will be arterial – Maintain direct pressure No IV on same arm as fistula A thrill will be felt – this is normal